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Vonafexor is a synthetic, orally active, non-steroidal and non-bile acid small molecule that acts as a highly selective agonist of the farnesoid X receptor (FXR), a nuclear receptor involved in bile acid regulation and metabolic processes. Developed primarily by ENYO Pharma (originator Poxel), vonafexor is being investigated for its potential to treat diseases with impaired kidney function such as Alport syndrome and chronic kidney disease (CKD), as well as metabolic-associated steatohepatitis (MASH) and non-alcoholic steatohepatitis (NASH). Preclinical studies have shown efficacy in reducing liver fibrosis, inflammation markers, liver fat content, and improving both liver enzymes and renal function. Clinical trials have demonstrated positive effects on hepatic fat reduction and improvements in biochemical markers of both liver inflammation and kidney function. Vonafexor has also been studied for antiviral activity against hepatitis B virus due to its FXR agonism[1][3][4][5][6][8].
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